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Evaluation of endocervical curettage findings at the time of cervical conization
TUESDAY, APRIL 29, 2003
GYNECOLOGY
curettings at the time of cervical conization to the other factors offers any incremental value in predicting residual disease.
Evaluation of Cone Biopsy Specimens: Wide Fischer Excisor Versus Cold Knife
STUDY DESIGN: We reviewed the charts and histopathology findings of 281 women who underwent an endocervical curettage at the time of cervical conization between January 1, 1992 and July 31, 2001. Age, histopathologic findings on the cervical conization, ectocervical margin, endocervical margin, and endocervical curettings were assessed. These findings were analyzed for a relationship to the presence of residual disease on subsequent follow-up (to include hysterectomy, repeat conization, colposcopically directed biopsies, endocervical curettage, and/or cytology).
Kenneth T. Borkowski, DO St. Francis Hospital and Medical Center, Hartford, CT
Samuel J. Vigneri, MD, Rachel Wellner, BS, and Nathan R. Fischer, MD OBJECTIVE: To determine if the number of positive margins on pathologic specimens is greater with the wide angle Fischer cone biopsy excisor (WAFCBE) or cold knife conization (CKC). METHODS: Data on patients undergoing WAFCBE were collected between October 1997 and January 2001. Inclusion criteria were an abnormal Papanicolaou smear result, inadequate colposcopy, and cytology with HGSIL on directed biopsy. Data were obtained retrospectively from operative records and pathology reports and prospectively from follow-up Papanicolaou smears at 3–18 months. The study was conducted with SFHMC IRB approval. These data were then compared to data derived through a meta-analysis of the published literature regarding CKC. RESULTS: The patient population consisted of 135 cases operated on at SFHMC using the WAFCBE and 2585 cases in the published literature using the CKC. The percentage of positive margins was 3.7% with the wide angle Fischer cone biopsy excisor, compared with 20.2% for cold knife conization. CONCLUSIONS: There is less margin involvement with the wide angle Fischer cone biopsy excisor than with a historical control of cold knife conization specimens.
RESULTS: Positive endocervical margin, positive ectocervical margin, positive endocervical curettings, and degree of dysplasia on conization were all individually significantly associated with the presence of residual disease. Age of the patient at the time of cervical conization was not statistically associated with the ability to predict residual disease. In the multivariate analysis, adding the results of the endocervical curettage to the endocervical margin status significantly increased the prediction of residual disease. However, when the degree of dysplasia and ectocervical margin status were included in the multivariate analysis, endocervical margin status and degree of dysplasia were the only statistically significant predictors of residual disease. CONCLUSIONS: An endocervical curettage at the time of cervical conization does not need to be routinely performed.
Genital Prolapse Symptoms and Quality-of-Life Parameters Associated With Pessary Use William E. Porter, MD University of Tennessee Health Science Center, Memphis, TN
Evaluation of Endocervical Curettage Findings at the Time of Cervical Conization Enrique Hernandez, MD
T. Russell Horton, MD, Torrance R. Lewis, MD, Val Y. Vogt, MD, and Robert L. Summitt, Jr, MD OBJECTIVE: To determine quality of life parameters predictive of successful ring pessary use. To also determine which urogenital symptoms are relieved or improved by pessary use.
Sanjay Ramchandani, MD, Karen L. Houck, MD, and John P. Gaughan, PhD
METHODS: All women with symptomatic prolapse were offered a ring pessary. Sixty-one women underwent a standard history and physical examination including pelvic organ prolapse quantification. Detailed symptom review and quality of life measurement questionnaires were completed initially and at 1 and 6 weeks.
OBJECTIVE: To evaluate the ability of various factors to predict residual disease after cervical conization. In particular, to evaluate whether adding the results of the endocervical
RESULTS: Among successful pessary patients, no change occurred in urogenital symptoms over 6 weeks. However, among those who failed, quality of life parameters were more
Temple University Hospital, Philadelphia, PA
50S
TUESDAY POSTERS
OBSTETRICS & GYNECOLOGY
GYNECOLOGY
curettings at the time of cervical conization to the other factors offers any incremental value in predicting residual disease.
Evaluation of Cone Biopsy Specimens: Wide Fischer Excisor Versus Cold Knife
STUDY DESIGN: We reviewed the charts and histopathology findings of 281 women who underwent an endocervical curettage at the time of cervical conization between January 1, 1992 and July 31, 2001. Age, histopathologic findings on the cervical conization, ectocervical margin, endocervical margin, and endocervical curettings were assessed. These findings were analyzed for a relationship to the presence of residual disease on subsequent follow-up (to include hysterectomy, repeat conization, colposcopically directed biopsies, endocervical curettage, and/or cytology).
Kenneth T. Borkowski, DO St. Francis Hospital and Medical Center, Hartford, CT
Samuel J. Vigneri, MD, Rachel Wellner, BS, and Nathan R. Fischer, MD OBJECTIVE: To determine if the number of positive margins on pathologic specimens is greater with the wide angle Fischer cone biopsy excisor (WAFCBE) or cold knife conization (CKC). METHODS: Data on patients undergoing WAFCBE were collected between October 1997 and January 2001. Inclusion criteria were an abnormal Papanicolaou smear result, inadequate colposcopy, and cytology with HGSIL on directed biopsy. Data were obtained retrospectively from operative records and pathology reports and prospectively from follow-up Papanicolaou smears at 3–18 months. The study was conducted with SFHMC IRB approval. These data were then compared to data derived through a meta-analysis of the published literature regarding CKC. RESULTS: The patient population consisted of 135 cases operated on at SFHMC using the WAFCBE and 2585 cases in the published literature using the CKC. The percentage of positive margins was 3.7% with the wide angle Fischer cone biopsy excisor, compared with 20.2% for cold knife conization. CONCLUSIONS: There is less margin involvement with the wide angle Fischer cone biopsy excisor than with a historical control of cold knife conization specimens.
RESULTS: Positive endocervical margin, positive ectocervical margin, positive endocervical curettings, and degree of dysplasia on conization were all individually significantly associated with the presence of residual disease. Age of the patient at the time of cervical conization was not statistically associated with the ability to predict residual disease. In the multivariate analysis, adding the results of the endocervical curettage to the endocervical margin status significantly increased the prediction of residual disease. However, when the degree of dysplasia and ectocervical margin status were included in the multivariate analysis, endocervical margin status and degree of dysplasia were the only statistically significant predictors of residual disease. CONCLUSIONS: An endocervical curettage at the time of cervical conization does not need to be routinely performed.
Genital Prolapse Symptoms and Quality-of-Life Parameters Associated With Pessary Use William E. Porter, MD University of Tennessee Health Science Center, Memphis, TN
Evaluation of Endocervical Curettage Findings at the Time of Cervical Conization Enrique Hernandez, MD
T. Russell Horton, MD, Torrance R. Lewis, MD, Val Y. Vogt, MD, and Robert L. Summitt, Jr, MD OBJECTIVE: To determine quality of life parameters predictive of successful ring pessary use. To also determine which urogenital symptoms are relieved or improved by pessary use.
Sanjay Ramchandani, MD, Karen L. Houck, MD, and John P. Gaughan, PhD
METHODS: All women with symptomatic prolapse were offered a ring pessary. Sixty-one women underwent a standard history and physical examination including pelvic organ prolapse quantification. Detailed symptom review and quality of life measurement questionnaires were completed initially and at 1 and 6 weeks.
OBJECTIVE: To evaluate the ability of various factors to predict residual disease after cervical conization. In particular, to evaluate whether adding the results of the endocervical
RESULTS: Among successful pessary patients, no change occurred in urogenital symptoms over 6 weeks. However, among those who failed, quality of life parameters were more
Temple University Hospital, Philadelphia, PA
50S
TUESDAY POSTERS
OBSTETRICS & GYNECOLOGY